ACA Blog

Oct 26, 2011

OCD, Security or Anxiety in a 5 year old

I’ve been seeing Tessa for approximately 5 months and each session was structured for her, something I didn’t realize I was doing, was it comfortable for her or me? Her mom told me she has been lying and manipulating and I wanted to talk about these issues with her before we did any play. I was way off my mark because she came into the office and sat on the couch and I told her what her mom said she had been doing. She looked at me with fear in her eyes and said emphatically “NO, I come in and sit on the couch and you bring the table over and put paper on it, then you get the markers and then you ask me to draw something and I do and THEN we talk. Wow, I was taken aback with this coming out of a 5 year old’s mouth. I didn’t realize how my routine affected her. I replied to her, “is that what you want me to do” and she said “YES”.

I did the routine and she began to loosen up, less tense and more calm. I saw the side of her come out where she wanted to lie and manipulate, and she’s only 5. She was very good at it and I addressed with her in words she could understand and she just giggled and laughed. I don’t know how much she comprehended but I know I learned a lot from her this session. Sometimes we get into a routine with our clients and a way we may not recognize, that routine may feel secure to our clients. Her strong desire to be in control may need to be watched as a red flag. For now I think I will follow my clients lead and slowly switch routines with her a little at a time to see what she can handle.

She has social phobia and I’m wondering if it has any connection to her desire to control things, and if she is not in control she becomes very anxious. I wrote this to remind us as counselors who get into a routine with our clients, to ask ourselves is the routine for them or us? I definitely have become acutely aware of how I conduct sessions especially for the children.

Kimberly Beck is a counselor and a doctoral candidate with a special interest in Self-injury. Other interests are PTSD, trauma, and Borderline personality disorder